Bothrops asper bite and post-traumatic stress disorder in Costa Rica: Report of two cases

Snakebite envenoming (SBE) is a public health problem of high impact worldwide. The psychiatric consequences of SBE have been poorly documented. Here we present in detail the phenomenology of two clinical cases of Bothrops asper snakebite post-traumatic stress disorder (SBPTSD) in Costa Rica. We suggest that there is a characteristic presentation of SBPTSD and hypothesize that main contributors to the development of this disorder are: the systemic inflammatory response, the repetition of events that put the patient's life at risk and the human innate fear of snakes. Protocols for the prevention, detection and treatment of PTSD in patients who suffer a SBE should be implemented, with at least one mental health care consultation during hospitalization and a 3–5 months follow-up after the discharge. [Display omitted] •Two cases of post-traumatic stress disorder after envenoming by the snake Bothrops asper are described.•The DSM 5 criteria for post-traumatic stress disorder in these two clinical cases are presented.•Possible mechanisms behind the development of this sequelae of envenoming are discussed.•Mental healthcare consultation should be provided to patients suffering snakebite envenomings.